I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

I have always love botox but my doctor stopped offering it and said xeomin would work better. I've waited three weeks with still no results, just some twitching near my right brow. Could I be resistant? I had the same amount/units as normal, if I switch back to botox will it still work. I have heard that it isn't recommended to go back and forth. I also take olive leaf extract and read that sometimes it is a natural antitoxin( use it for acne) Thanks!

Doctor Answers (20)

Xeomin vs Botox

June 20th, 2012

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It is quite unlikely that you developed resistance to Xeomin. Although it is quite rare, patients are much more likely to develop resistance to Botox. It is possible that your Xeomin dose needs to be tweaked, for best results.

I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

September 1st, 2013

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I have had excellent results with Xeomin and I now routinely offer it as a neuromodulator (along with Botox and Dysport). It is perfectly reasonable to go back and try the Botox to see if that gives you a better result but it is equally important to make sure that you are receiving the same number of units (1 of Xeomin = 1 of Botox) and that the solution is fresh (there is some question as to exactly how long each lasts once it is made up but I try to make it fresh for each patient, or at least within just a few hours). Within those parameters you should be as happy with your Xeomin treatments as you have been with Botox.

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Differences in Xeomin activity more likely relate to dose

May 1st, 2013

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It is more likely that differences in activity between the available type A botulinum neurotoxins - Xeomin, Botox, and Dysport - are due to the amount given and amount needed in the individual person to achieve a desired result. There are individual variations in the activity of ALL of the toxins, and while many injectors use convenient "conversion factors," like 2 or 3:1 for Dysport to Botox units or 1:1 for Xeomin to Botox units, the truth is that these conversions are only guidelines and won't work 100 % of the time for all people. Rather than totally discard Xeomin or any of the toxins, if you wish to convert, my advice is to keep working with your physician to determine YOUR optimal dose of your chosen neurotoxin based on your desired result.

Botox vs. Xeomin

February 28th, 2013

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The active drug in each of these products is the same, therefore treatment outcomes should be similar. There is no question that some patients prefer one product over the other. They are not interchangeable from a dosing standpoint so it may be that the dose of Xeomin you received may need to be adjusted.

Xeomin Treatment

March 4th, 2012

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Hello and thank you for the question.

Our practice has been using Xeomin since it became commercially available last year. From my experience, the efficacy of Xeomin is comparable with that of Botox and Dysport. While you may have a "resistance" to Xeomin, the likelihood is low.

Botox dysport and xeomin should be similar

February 12th, 2012

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There shouldn't be a reason that any one of the three botulinum toxins, Dysport, Botox or Xeomin, is signficantly better than the others. One patient may like one, whereas another patient may prefer the effects of another. Some may say there product works a day or more sooner and others may say there is less free protein to cause immune reactions but I the three products may be quite similar. The number of units for each to be equivalent, may differ and more studies may need to be done.

Xeomin vs Botox

February 7th, 2012

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Xeomin is the newest neuromodulator available in the U.S. and thus far, only experienced injectors are being given access to it for patient use. Therefore, each physician who answers here has excellent credibility. I have been using it in patients who have previously had Botox, as well as some who have never been treated, and I am diluting it exactly the same as Botox. My results thus far have been equivalent between the two products for cosmetic purposes. I am able to offer Xeomin at a slightly lower cost to the patient, which is attractive to many.

I have one long term patient who gets injections for essential blepharospasm (uncontrolled eyelid twitching), and when she switched to Xeomin she did not get nearly as good a result as with Botox. Her spasms went away only for three weeks instead of the three months she gets with Botox. In her case, we have gone back to Botox.

Provided that everything else is the same (injector, dilution, location of injections), I think that you are similar to my one patient in that, for unexplained reasons, Botox works better for you than Xeomin. There should be no problem with going back to Botox and you should get the same good result you did before.

Xeomin vs Botox

February 6th, 2012

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Unfortunately, the study cited below did not compare the same dosage of Xeomin to the same dosage of Botox which makes consumers and physicians assume you need more Xeomin to be equivalent to Botox. It is quite possible that the study would have found the EXACT same results (equivalence with a trend toward Botox) using 20 units of Botox and 20 units of Xeomin. It is unclear why they did this and it does make me suspect of their motives. I love Botox and have been using Xeomin 1:1 and have been pleased in most but not all patients. As many other reviewers said, there may be individual differences, but otherwise they are all good products.

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